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Welcome to the South Asian Health Solution


This is not just for South Asians. It’s for anyone from any culture who struggles with insulin resistance, losing fat, preventing chronic illness, or achieving their own personal health goals. South Asians have unfortunately become a world leader in insulin resistance, the underlying condition that causes most cases of diabetes, heart disease, and obesity, in addition to being connected to virtually every major chronic health condition, from Alzheimer’s disease and cancer to arthritis and premature aging.


I now exclusively see South Asian consult patients in my clinic and design health education and wellness programs for some of the most successful companies in the world. This blog will share my professional experience, cutting edge research, and my own personal journey in overcoming insulin resistance and achieving optimal health.



Is Full-Fat Dairy Ok?

by Ron on September 30, 2014

milkBackground

The latest study on dairy fat once again confirms that instead of pointing our finger at the full-fat milk in that cereal bowl, it’s the so-called healthy whole grain cereal or the glass of orange juice on the side we need to shift our focus to as the real culprit behind diabetes and heart disease.  This study actually showed a reduction in diabetes risk in the individuals who consumed more dairy fat.  I have a large number of insulin resistant vegetarian Indians in my practice and in an effort to get them to reduce their excessive carbohydrate intake (their primary problem), I have them re-introduce more dairy fats into their diet (whole milk, yogurt, butter, paneer/cheese,etc.) in addition to other healthy fats. I closely monitor their weight, lipids, glucose and inflammatory markers and have yet to see any of these numbers be adversely affected by replacing their excess carbohydrates with sensible portions of dairy fat.

What’s Healthy About Dairy Fat?

How could dairy fat possibly be good for your health?  The dairy fat is not only more satiating (preventing overeating later in the day), but is nutrient dense and reduces inflammation, the primary cause of most chronic health condtions.  This applies to both adults and kids (see “Children’s Corner”at the end of this post).  Let’s summarize some of the valuable components of dairy fat:

1. Trans-palmitoleic acid: This is a fatty acid found in milk, cheese, yogurt, and butter that is associated with improved cholesterol, lower insulin resistance, lower inflammation and lower diabetes risk.  Read the Harvard summary here.  Not to be confused with the other deadly trans fat resulting from chemically processed, hydrogenated vegetable oils which do the exact opposite…they worsen cholesterol, increase inflammation, and raise heart disease risk.

2. Fat Soluble Vitamins: Milk contains the fat-soluble vitamins, A, D, E and K.  The fat in the milk protects these vitamins, allowing them to survive longer in the milk container.  When you remove the fat (low-fat or skim milk), these fats don’t last.  In addition to fat-soluble vitamins, milk also has B-vitamins (B12, Folate, Niacin, etc.) and vitamin C.

3. Vitamin K2: I mentioned vitamin K above, but there are actually 2 types, vitamin K1 and vitamin K2.  Vitamin K1 is more commonly known as playing a key role with blood clotting, but its unsung partner K2 helps traffic calcium away from your soft tissues and into your bones and teeth where they belong.   Health professionals have made a big deal for many years about getting enough calcium into your diet, but the more critical nutritional elements of building stronger bones are vitamin D to increase calcium absorption from your intestines and vitamin K2 to send the absorbed calcium to the right place.  Hard and soft cheeses are good sources of vitamin K2, especially gouda.  Other sources are egg yolk, butter, and natto (fermented soybeans).   You can now see how a low-fat diet which typically eliminates full fat milk, cheese, butter and egg yolks is a sure way to promote vitamin K2 deficiency.

4. Butyrate: This is a short chain fatty acid (SCFA) produced in the intestine after bacteria break down dietary fiber.  Aside from your gut bacteria making its own butyrate from fiber, you can also get butyrate from butter.  In fact “butter” gets its name from the “butyr” in butyrate.  Studies have shown butyrate has an effect on reducing insulin resistance and inflammation.  This may explain why healthy sources of dietary fiber have health-promoting benefits.

You can now see how a low-fat diet which typically eliminates full fat milk, cheese, butter and egg yolks can promote inflammation by leading to multiple micronutrient deficiencies and by reducing the amount of heart-healthy fats like trans-palmitoleic acid and butyrate.  One common question I get is whether dairy products increase insulin?  The answer is yes.  A glass of milk will likely cause a spike in insulin due to the combined effects of lactose (milk sugar) and certain amino acids in milk like leucine, and if excess insulin is one of our enemies, how could dairy be good for us?  My thought is that the short-term spike in insulin is a temporary nutrient response, but the long-term effects of dairy fat on insulin resistance are favorable due to the healthy fats and micronutrients we discussed above.

Does The Type of Dairy You Consume Matter?

There is now a big health movement towards consuming raw milk (unpasteurized, non-homogenized) which maximizes all the healthy nutrients and fats we discussed while also being rich in healthy bacteria.  However, to prevent serious illness, unpasteurized milk must be handled very carefully and must come from a clean, reliable source.  If you’re not ready to go raw, you can pick organic, grass-fed milk as the next best alternative.  Fermented dairy sources like yogurt, kefir and cheese provide healthy gut bacteria in addition to the above mentioned health benefits.  Be sure to read nutrition labels closely.  Notice how most low-fat or non-fat yogurts, especially with that sugar-filled pocket they call “fruit,” have a long list of unnatural chemical additives.  A good, clean yogurt should just have milk/cream and bacteria listed in the ingredients.

When Might Dairy Not Be Right For You?

I’ve talked about the benefits from dairy on major conditions like diabetes and heart disease, but there are many who have intolerances to dairy protein that lead to skin conditions (acne, eczema, etc.), sinusitis, and digestive issues (leaky gut, irritable bowel syndrome, etc.) to name a few.  Lactose intolerance is another issue more common in some cultures than others, which can contribute to digestive discomfort.  The simplest thing to do if you are experiencing any of these issues is to go on a dairy-free trial to see if your skin clears up or your intestinal symptoms improve.  If you’re still craving milk, perhaps try almond, hemp or coconut milk as lactose-free alternatives.  By the way, raw milk has the lactase enzyme which helps your body break down lactose.  Pasteurization destroys lactase, so if you are lactose intolerant from drinking pasteurized milk, you may tolerate raw milk.

Children’s Corner

Almost any nutrition handout given to an overweight child’s family will state somewhere near the top to switch to low-fat or skim milk.  Based on everything we discussed so far, you should suspect that this is the exact opposite of what should be done, right?  If you said yes, you are absolutely correct and a growing list of research studies supports the fact that kids consuming skim and 1% milk were more likely to be overweight than those who consume whole milk.  You can find these studies, here, here, and here.  Sending your child to school after he downs a glass of skim milk and a multi-grain waffle will not keep him full and will instead make him crave more sugar, in addition to promoting multiple nutrient deficiencies.  If you feel unsure about making this change, try it and monitor your child’s weight for the next several weeks.  If it’s the same or lower, continue the dairy fat.  If the weight goes up, be sure there aren’t other sources for potential weight gain (extra sugar, carbs or reduced physical activity) contributing.  Also be sure to not overdo it with milk in babies and toddlers since excess milk intake can promote iron deficiency and constipation.

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Carb Trafficking, Body Fat Storage, and Insulin Resistance

September 9, 2014

SOME BACKGROUND After taking a bit of a hiatus over the summer from writing posts, I’m now back with a vengeance delivering this detailed post on carb trafficking and insulin resistance.  Whenever applicable, I’m going to end my posts with a Children’s Corner section reflecting the experience of my wife Shally (a pediatrician), who works on […]

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What Color Is Your Fat?

July 21, 2014

I’ll Have The Brown Fat Please If you think that all fat cells are inert, metabolically inactive storage containers that swell up with triglycerides, especially when we overindulge in carbohydrates, think again.  The two major types of fat produced by our body are brown and white fat.  White fat is relatively inert and fits our […]

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Our Ancestors Didn’t Need Dental Check Ups, But You Do (Guest Post)

July 4, 2014

I wanted to introduce my good friend Dr.Mark Burhenne, accomplished dentist who runs the wonderful blog, Ask The Dentist.  He has kindly authored the following post which discusses the link between our loss of oral bacterial diversity with dental and chronic inflammatory disease.  Mark sees a large number of South Asian patients in his clinic […]

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Are We Aging Faster?

June 23, 2014

Our modern lifestyles have turned chronological age into a virtually insignificant number.  Aging is not just the number of years you’ve inhabited planet Earth, but rather the degree of wear and tear your body, brain, and vital organs are expressing at a given point in time.  When I came out of medical training and started […]

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See This Movie

June 6, 2014

FED UP: The Movie If a picture is worth a thousand words, a movie is worth even more.  I encourage you to not walk, but run and see the movie FED UP, playing in movie theaters, which highlights the insidious, corporate-driven forces behind our current obesity epidemic.  I saw this with my wife and two […]

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Can Stress Trigger Disease in Otherwise Healthy Individuals?

May 23, 2014

The connection between stress, inflammation and chronic disease has become quite clear to me in my practice.  Let’s talk about a patient of mine (name and details changed) to illustrate the point and then discuss some of the supportive science. Case Study Dev (name changed) is a 45-year-old hard driving Silicon Valley executive who was […]

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Why Saturated Fat Is Feared

May 4, 2014

Let me first start this post off with my disclaimer.  If you are inactive and already eating a diet high in excess carbohydrates, your are likely in constant fat storage mode due to excess levels of the hormone insulin.  In this case, eating liberal amounts of saturated fat is not healthy.  Please don’t use this […]

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Are You Digitally Addicted: The “CAGED” Criteria

April 7, 2014

I saw a patient recently who I suspected had issues with alcohol abuse.  A standard questionnaire we learned from medical training to identify alcohol addiction is known as the CAGE Criteria where “CAGE” is an acronym for the following: C Have you ever felt you should Cut down on your drinking? A Have people Annoyed you by criticizing your drinking? G Have […]

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The Most Important Exercise You’re Not Doing Enough Of

March 28, 2014

We need to completely re-evaluate our approach to exercise given the weight of current evidence.  Back in the days when physical activity was a natural part of our life and daily habits, it was assumed that we took enough steps to interrupt the damaging metabolic effects of prolonged sitting frequently enough to disrupt fat storage […]

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